Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-05T13:55:20.814Z Has data issue: false hasContentIssue false
  • English
  • Français

Computerized assessment of cognition in schizophrenia: Promises and pitfalls of CANTAB

Published online by Cambridge University Press:  16 April 2020

Marie-Noëlle Levaux ,
Stéphane Potvin ,
Amir Ali Sepehry ,
Juliette Sablier ,
Adrianna Mendrek  and
Emmanuel Stip
Marie-Noëlle Levaux
Affiliation:
Centre de recherche Fernand-Seguin, Hospital Louis-H Lafontaine, Montreal, Quebec, Canada Department of Psychology, Faculty of Arts and Sciences, University of Montreal, Montreal, Quebec, Canada
Stéphane Potvin
Affiliation:
Centre de recherche Fernand-Seguin, Hospital Louis-H Lafontaine, Montreal, Quebec, Canada Department of Biomedical Sciences, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
Amir Ali Sepehry
Affiliation:
Centre de recherche Fernand-Seguin, Hospital Louis-H Lafontaine, Montreal, Quebec, Canada Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada Department of Biomedical Sciences, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
Juliette Sablier
Affiliation:
Centre de recherche Fernand-Seguin, Hospital Louis-H Lafontaine, Montreal, Quebec, Canada Department of Biomedical Sciences, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
Adrianna Mendrek
Affiliation:
Centre de recherche Fernand-Seguin, Hospital Louis-H Lafontaine, Montreal, Quebec, Canada Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
Emmanuel Stip*
Affiliation:
Centre de recherche Fernand-Seguin, Hospital Louis-H Lafontaine, Montreal, Quebec, Canada Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
*
*Corresponding author at: Centre de recherche Fernand-Seguin, 7331 Hochelaga, Montreal, Quebec, Canada, H1N 3V2. Tel.: +1 (514) 251 4015; fax: +1 (514) 251 2617. E-mail address: [email protected] (E. Stip).
Get access

Abstract

Objective

Over the last decade, the Cambridge Neuropsychological Test Automated Battery (CANTAB), which comprises visuo-spatial tasks, has been utilized in cognitive studies of schizophrenia. A clear approach concerning the usage of CANTAB for the appraisal of neurocognitive dysfunction in schizophrenia is currently lacking.

Method

In this paper, we have first reviewed the overall applications of CANTAB and then evaluated methodological strengths and weaknesses of CANTAB as a neurocognitive battery for schizophrenia. We carried out a systematic search and assessment of studies where CANTAB was utilized to measure cognitive function in schizophrenia. We have also attempted to quantify the available data and perform a meta-analysis, but this approach turned out to be still premature.

Results

CANTAB has enabled researchers to highlight significant deficits affecting broad cognitive domains in schizophrenia, such as working memory, decision-making, attention, executive functions and visual memory. So far, the most consistent deficit observed with CANTAB testing has been attentional set-shifting, suggestive of fronto-striatal dysfunctions. In addition, preliminary evidence points towards the potential use of CANTAB to identify cognitive predictors of psychosocial functioning, to describe the relationships between symptoms and cognition, and to measure the impact of pharmacological agents on cognitive functioning.

Conclusion

CANTAB has been used successfully to highlight the range of visuo-spatial cognitive deficits in schizophrenia, producing similar results to those obtained with some traditional neuropsychological tests. Further studies validating the use of CANTAB following the standard set by Measurement And Treatment Research to Improve Cognition in Schizophrenia (MATRICS) are warranted.

Keywords

SchizophreniaCognitionCANTABMemory
Type
Review
Information
European Psychiatry , Volume 22 , Issue 2 , March 2007 , pp. 104 - 115
Copyright
Copyright © Elsevier Masson SAS 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Almeida, O.P., Howard, R.J., Levy, R., David, A.S., Morris, R.G., Sahakian, B.J.Cognitive features of psychotic states arising in late life (late paraphrenia). Psychol Med 1995;25(4):685–698.CrossRefGoogle Scholar
Almeida, O.P., Howard, R.J., Levy, R., David, A.S., Morris, R.G., Sahakian, B.J.Clinical and cognitive diversity of psychotic states arising in late life (late paraphrenia). Psychol Med 1995;25(4):699–714.CrossRefGoogle Scholar
Badcock, J.C., Michiel, P.T., Rock, D.Spatial working memory and planning ability: contrasts between schizophrenia and bipolar I disorder. Cortex 2005;41(6):753–763.CrossRefGoogle ScholarPubMed
Baker, S.C., Rogers, R.D., Owen, A.M., Frith, C.D., Dolan, R.J., Frackowiak, R.S.et al.Neural systems engaged by planning: a PET study of the Tower of London task. Neuropsychologia 1996;34(6):515–526.CrossRefGoogle ScholarPubMed
Barnes, T.R., Hutton, S.B., Chapman, M.J., Mutsatsa, S., Puri, B.K., Joyce, E.M.West London first-episode study of schizophrenia. Clinical correlates of duration of untreated psychosis. Br J Psychiatry 2000;177:207–211.CrossRefGoogle ScholarPubMed
Barnes, T.R., Mutsatsa, S.H., Hutton, S.B., Watt, H.C., Joyce, E.M.Comorbid substance use and age at onset of schizophrenia. Br J Psychiatry 2006;188:237–242.CrossRefGoogle ScholarPubMed
Bartok, E., Berecz, R., Glaub, T., Degrell, I.Cognitive functions in prepsychotic patients. Prog Neuropsychopharmacol Biol Psychiatry 2005;29(4):621–625.CrossRefGoogle ScholarPubMed
Berg, E.A simple objective technique for measuring flexibility in thinking. J Gen Psychol 1948;39:15–22.CrossRefGoogle ScholarPubMed
Chouinard, S., Poulin, J., Stip, E., Godbout, R., Lalonde, P., Melun, J.P.et al.Cognitive performance in patients with schizophrenia after rivastigmine treatment. XX International Congress on Schizophrenia Research. Schizophr Bull April 2005;2005:478.Google Scholar
Elliott, R., McKenna, P.J., Robbins, T.W., Sahakian, B.J.Neuropsychological evidence for frontostriatal dysfunction in schizophrenia. Psychol Med 1995;25(3):619–630.CrossRefGoogle Scholar
Elliott, R., McKenna, P.J., Robbins, T.W., Sahakian, B.J.Specific neuropsychological deficits in schizophrenic patients with preserved intellectual function. Cognit Neuropsychiatry 1998;3(3):45–70.CrossRefGoogle Scholar
Elliott, R., Sahakian, B.J., McKay, A.P., Herrod, J.J., Robbins, T.W., Paykel, E.S.Neuropsychological impairments in unipolar depression: the influence of perceived failure on subsequent performance. Psychol Med 1996;26(5):975–989.CrossRefGoogle ScholarPubMed
Elliott, R., Sahakian, B.J.The neuropsychology of schizophrenia: relations with clinical and neurobiological dimensions. Psychol Med 1995;25(3):581–594.CrossRefGoogle ScholarPubMed
Fowler, K.S., Saling, M.M., Conway, E.L., Semple, J.M., Louis, W.J.Paired associate performance in the early detection of DAT. J Int Neuropsychol Soc 2002;8(1):58–71.CrossRefGoogle ScholarPubMed
Fray, P.J., Robbins, T.W., Sahakian, B.J.Neuropsychiatric applications of CANTAB. Int J Geriatr Psychiatry 1996;11(4):329–336.3.0.CO;2-6>CrossRefGoogle Scholar
Gabrovska-Johnson, V.S., Scott, M., Jeffries, S., Thacker, N., Baldwin, R.C., Burns, A.et al.Right-hemisphere encephalopathy in elderly subjects with schizophrenia: evidence from neuropsychological and brain imaging studies. Psychopharmacology (Berl) 2003;169(3-4):367–375.CrossRefGoogle ScholarPubMed
Gaffan, D.Recognition impaired and association intact in the memory of monkeys after transection of the fornix. J Comp Physiol Psychol 1974;86(6):1100–1109.CrossRefGoogle ScholarPubMed
Green, M.F., Kern, R.S., Heaton, R.K.Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res 2004;72(1):41–51.CrossRefGoogle ScholarPubMed
Green, M.F., Nuechterlein, K.H.The MATRICS initiative: developing a consensus cognitive battery for clinical trials. Schizophr Res 2004;72(1):1–3.CrossRefGoogle ScholarPubMed
Hamilton, J.M., Salmon, D.P., Corey-Bloom, J., Gamst, A., Paulsen, J.S., Jerkins, S.et al.Behavioural abnormalities contribute to functional decline in Huntington's disease. J Neurol Neurosurg Psychiatry 2003;74(1):120–122.CrossRefGoogle ScholarPubMed
Hutton, S., Huddy, The relationship between antisaccades, smooth pursuit, and executive dysfunction in first-episode schizophrenia. Biol Psychiatry 2004;56(8):553–559.CrossRefGoogle ScholarPubMed
Hutton, S.B., Cuthbert, I., Crawford, T.J., Kennard, C., Barnes, T.R., Joyce, E.M.Saccadic hypometria in drug-naive and drug-treated schizophrenic patients: a working memory deficit?. Psychophysiology 2001;38(1):125–132.CrossRefGoogle ScholarPubMed
Hutton, S.B., Huddy, V., Barnes, T.R., Robbins, T.W., Crawford, T.J., Kennard, C.et al.The relationship between antisaccades, smooth pursuit, and executive dysfunction in first-episode schizophrenia. Biol Psychiatry 2004;56(8):553–559.CrossRefGoogle ScholarPubMed
Hutton, S.B., Murphy, F.C., Joyce, E.M., Rogers, R.D., Cuthbert, I., Barnes, T.R.et al.Decision making deficits in patients with first-episode and chronic schizophrenia. Schizophr Res 2002;55(3):249–257.CrossRefGoogle ScholarPubMed
Hutton, S.B., Puri, B.K., Duncan, L.J., Robbins, T.W., Barnes, T.R., Joyce, E.M.Executive function in first-episode schizophrenia. Psychol Med 1998;28(2):463–473.CrossRefGoogle ScholarPubMed
Joyce, E., Hutton, S., Mutsatsa, S., Gibbins, H., Webb, E., Paul, S.et al.Executive dysfunction in first-episode schizophrenia and relationship to duration of untreated psychosis: the West London Study. Br J Psychiatry Suppl 2002;43:s38–s44.CrossRefGoogle ScholarPubMed
Joyce, E.M., Hutton, S.B., Mutsatsa, S.H., Barnes, T.R.Cognitive heterogeneity in first-episode schizophrenia. Br J Psychiatry 2005;187:516–522.CrossRefGoogle ScholarPubMed
Joyce, E.M., Robbins, T.W.Frontal lobe function in Korsakoff and non-Korsakoff alcoholics: planning and spatial working memory. Neuropsychologia 1991;29(8):709–723.CrossRefGoogle ScholarPubMed
Karoumi, B., Ventre-Dominey, J., Vighetto, A., Dalery, J., d'Amato, T.Saccadic eye movements in schizophrenic patients. Psychiatry Res 1998;77(1):9–19.CrossRefGoogle ScholarPubMed
Lawrie, S.M., Ingle, G.T., Santosh, C.G., Rogers, A.C., Rimmington, J.E., Naidu, K.P.et al.Magnetic resonance imaging and single photon emission tomography in treatment-responsive and treatment-resistant schizophrenia. Br J Psychiatry 1995;167(2):202–210.CrossRefGoogle ScholarPubMed
Lowe, C., Rabbitt, P.Test/re-test reliability of the CANTAB and ISPOCD neuropsychological batteries: theoretical and practical issues. Cambridge Neuropsychological Test Automated Battery. International Study of Post-Operative Cognitive Dysfunction. Neuropsychologia 1998;36(9):915–923.CrossRefGoogle Scholar
Luciana, M.Practitioner review: computerized assessment of neuropsychological function in children: clinical and research applications of the Cambridge Neuropsychological Testing Automated Battery (CANTAB). J Child Psychol Psychiatry 2003;44(5):649–663.CrossRefGoogle Scholar
Mathes, B., Wood, S.J., Proffitt, T.M., Stuart, G.W., Buchanan, J.A., Velakoulis, D.et al.Early processing deficits in object working memory in first-episode schizophreniform psychosis and established schizophrenia. Psychol Med 2005;35(7):1053–1062.CrossRefGoogle ScholarPubMed
McCartan, D., Bell, R., Green, J.F., Campbell, C., Trimble, K., Pickering, A.et al.The differential effects of chlorpromazine and haloperidol on latent inhibition in healthy volunteers. J Psychopharmacol 2001;15(2):96–104.CrossRefGoogle ScholarPubMed
McIntosh, A.M., Harrison, L.K., Forrester, K., Lawrie, S.M., Johnstone, E.C.Neuropsychological impairments in people with schizophrenia or bipolar disorder and their unaffected relatives. Br J Psychiatry 2005;186:378–385.CrossRefGoogle ScholarPubMed
Milner, B.Interhemispheric differences in the localization of psychological processes in man. Br Med Bull 1971;27(3):272–277.CrossRefGoogle ScholarPubMed
Mishkin, M.A memory system in the monkey. Philos Trans R Soc Lond B Biol Sci 1982;298(1089):83–95.Google ScholarPubMed
Owen, A.M., Evans, A.C., Petrides, M.Evidence for a two-stage model of spatial working memory processing within the lateral frontal cortex: a positron emission tomography study. Cereb Cortex 1996;6(1):31–38.CrossRefGoogle ScholarPubMed
Owen, A.M., Morris, R.G., Sahakian, B.J., Polkey, C.E., Robbins, T.Double-dissociation of memory and executive functions in working memory tasks following frontal-lobe excisions, temporal lobe excisions or amygdalo-hippocampectomy in man. Brain 1997;119(5):1597–1615.CrossRefGoogle Scholar
Owen, A.M., Sahakian, B.J., Semple, J., Polkey, C.E., Robbins, T.W.Visuo-spatial short-term recognition memory and learning after temporal lobe excisions, frontal lobe excisions or amygdalo-hippocampectomy in man. Neuropsychologia 1995;33(1):1–24.CrossRefGoogle ScholarPubMed
Pampoulova, T., Potvin, S., Sepehry, A.A., Levaux, M.N., Feltrin, C.E.S.Lack of cognitive toxicity during high-dose quetiapine therapy. Schizophr Res 2006;81(Suppl S):138.Google Scholar
Pantelis, C., Barber, F.Z., Barnes, T.R., Nelson, H.E., Owen, A.M., Robbins, T.W.Comparison of set-shifting ability in patients with chronic schizophrenia and frontal lobe damage. Schizophr Res 1999;37(3):251–270.CrossRefGoogle ScholarPubMed
Pantelis, C., Barnes, T.R., Nelson, H.E., Tanner, S., Weatherley, L., Owen, A.M.et al.Frontal-striatal cognitive deficits in patients with chronic schizophrenia. Brain 1997;120(Pt 10):1823–1843.CrossRefGoogle ScholarPubMed
Pantelis, C., Stuart, G.W., Nelson, H.E., Robbins, T.W., Barnes, T.R.Spatial working memory deficits in schizophrenia: relationship with tardive dyskinesia and negative symptoms. Am J Psychiatry 2001;158(8):1276–1285.CrossRefGoogle ScholarPubMed
Potvin, S., Briand, C., Prouteau, A., Bouchard, R.H., Lipp, O., Lalonde, P.et al.CANTAB explicit memory is less impaired in addicted schizophrenia patients. Brain Cogn 2005;59(1):38–42.CrossRefGoogle ScholarPubMed
Potvin, S., Briand, C., Prouteau, A., Bouchard, R.H., Lipp, O., Lalonde, P.et al.CANTAB explicit memory is less impaired in addicted schizophrenia patients. Brain Cogn 2005;59(1):38–42.CrossRefGoogle ScholarPubMed
Potvin, S., Stip, E., Lipp, O., Mancini-Marie, A., Elie, R., Demers, M.F.et al.Quetiapine in patients with comorbid schizophrenia-spectrum and substance use disorders: an open-label trial. Curr Med Res Opin 2006;22(7):1277–1285.CrossRefGoogle Scholar
Prouteau, A., Verdoux, H., Briand, C., Lesage, A., Lalonde, P., Nicole, L.et al.The crucial role of sustained attention in community functioning in outpatients with schizophrenia. Psychiatry Res 2004;129(2):171–177.CrossRefGoogle ScholarPubMed
Prouteau, A., Verdoux, H., Briand, C., Lesage, A., Lalonde, P., Nicole, L.et al.Cognitive predictors of psychosocial functioning outcome in schizophrenia: a follow-up study of subjects participating in a rehabilitation program. Schizophr Res 772-32005 343–353.CrossRefGoogle Scholar
Prouteau, A., Verdoux, H., Briand, C., Lesage, A., Lalonde, P., Nicole, L.et al.Self-assessed cognitive dysfunction and objective performance in outpatients with schizophrenia participating in a rehabilitation program. Schizophr Res 2004;69(1):85–91.CrossRefGoogle Scholar
Regier, D.A., Farmer, M.E., Rae, D.S., Locke, B.Z., Keith, S.J., Judd, L.L.et al.Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA 1990;264(19):2511–2518.CrossRefGoogle ScholarPubMed
Ritsner, M.S., Blumenkrantz, H., Dubinsky, T., Dwolatzky, T.The detection of neurocognitive decline in schizophrenia using the Mindstreams Computerized Cognitive Test Battery. Schizophr Res 2006;82(1):39–49.CrossRefGoogle ScholarPubMed
Robbins, T.W., James, M., Owen, A.M., Sahakian, B.J., McInnes, L., Rabbitt, P.Cambridge Neuropsychological Test Automated Battery (CANTAB): a factor analytic study of a large sample of normal elderly volunteers. Dementia 1994;5(5):266–281.Google ScholarPubMed
Robbins, T.W.Dissociating executive functions of the prefrontal cortex. Philos Trans R Soc Lond B Biol Sci 1996;351(1346):1463–1470 (discussion 70–1).Google ScholarPubMed
Robbins, T.W.The case of frontostriatal dysfunction in schizophrenia. Schizophr Bull 1990;16(3):391–402.CrossRefGoogle Scholar
Rosvald, H.E., Mirsky, A.F., Sarason, I., Bransome, E.D.J., Beck, L.D.A continuous performance test of brain damage. J Consult Psychol 1956;20(5):343–350.CrossRefGoogle Scholar
Sahakian, B.J., Coull, J.J., Hodges, J.R.Selective enhancement of executive function by idazoxan in a patient with dementia of the frontal lobe type. J Neurol Neurosurg Psychiatry 1994;57(1):120–121.CrossRefGoogle Scholar
Sahakian, B.J., Morris, R.G., Evenden, J.L., Heald, A., Levy, R., Philpot, M.et al.A comparative study of visuospatial memory and learning in Alzheimer-type dementia and Parkinson's disease. Brain 1988;111(Pt 3):695–718.CrossRefGoogle ScholarPubMed
Sahgal, A., Sahakian, B.J., Robbins, T.W., Wray, C.J.Detection of visual memory and learning deficits in Alzheimer's disease using the Cambridge Neuropsychological Test Automated Battery. Dementia 1991;2(3):150–158.Google Scholar
Shallice, T.Specific impairments of planning. Philos Trans R Soc Lond B Biol Sci 1982;298(1089):199–209.Google ScholarPubMed
Squire, L.R.Memory and the hippocampus: a synthesis from findings with rats, monkeys, and humans. Psychol Rev 1992;99(2):195–231.CrossRefGoogle ScholarPubMed
Stip, E., Sepehry, A.A., Prouteau, A., Briand, C., Nicole, L., Lalonde, P.et al.Cognitive discernible factors between schizophrenia and schizoaffective disorder. Brain Cogn 2005;59(3):292–295.CrossRefGoogle ScholarPubMed
Strauss, E., Sherman, E.M.S., Spreen, O.CANTAB A compendium of neuropsychological tests: administration, norms, and commentary. 3rd ed.New York: Oxford University Press; 2006. p. 415–424.Google Scholar
Turner, D.C., Clark, L., Pomarol-Clotet, E., McKenna, P., Robbins, T.W., Sahakian, B.J.Modafinil improves cognition and attentional set shifting in patients with chronic schizophrenia. Neuropsychopharmacology 2004;29(7):1363–1373.CrossRefGoogle ScholarPubMed
Tyson, P.J., Laws, K.R., Roberts, K.H., Mortimer, A.M.A longitudinal analysis of memory in patients with schizophrenia. J Clin Exp Neuropsychol 2005;27(6):718–734.CrossRefGoogle ScholarPubMed
Tyson, P.J., Laws, K.R., Roberts, K.H., Mortimer, A.M.Stability of set-shifting and planning abilities in patients with schizophrenia. Psychiatry Res 2004;129(3):229–239.CrossRefGoogle ScholarPubMed
Wood, S.J., Pantelis, C., Proffitt, T., Phillips, L.J., Stuart, G.W., Buchanan, J.A.et al.Spatial working memory ability is a marker of risk-for-psychosis. Psychol Med 2003;33(7):1239–1247.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.